Early Weaning of HIV-Exposed Uninfected Infants and Risk of Serious Gastroenteritis: Findings from Two Perinatal HIV Prevention Trials in Kampala, Uganda

Carolyne ONYANGO-MAKUMBI; Danstan BAGENDA; J Brooks Jackson; Laura A GUAY; Antony MWATHA; Saad B OMER; Philippa MUSOKE; Francis MMIRO; Sheryl L ZWERSKI; Brenda ASIIMWE KATEERA; Maria MUSISI; Mary Glenn FOWLER

doi:10.1097/QAI.0b013e3181bdf68e

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Early Weaning of HIV-Exposed Uninfected Infants and Risk of Serious Gastroenteritis: Findings from Two Perinatal HIV Prevention Trials in Kampala, Uganda

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Early Weaning of HIV-Exposed Uninfected Infants and Risk of Serious Gastroenteritis: Findings from Two Perinatal HIV Prevention Trials in Kampala, Uganda

Carolyne ONYANGO-MAKUMBI, Danstan BAGENDA, J Brooks Jackson, Laura A GUAY, Antony MWATHA, Saad B OMER, Philippa MUSOKE, Francis MMIRO, Sheryl L ZWERSKI, Brenda ASIIMWE KATEERA, …

Journal of acquired immune deficiency syndromes (1999), Vol.53(1), pp.20-27

2010

DOI: 10.1097/QAI.0b013e3181bdf68e

PMCID: PMC2888913

PMID: 19779355

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Abstract

Objective: To assess serious gastroenteritis risk and mortality associated with early cessation of breastfeeding in infants enrolled in 2 prevention of maternal-to-child HIV-transmission trials in Uganda. Methods: We used hazard rates to evaluate serious gastroenteritis events by month of age and mortality among HIV-exposed uninfected infants enrolled in the HIV Network for Prevention Trials (HIVNET 012) (1997-2001) and HIV hyperimmune globulin (HIVIGLOB)/nevirapine (NVP) (2004-2007) trials. HIV-infected mothers were counseled using local infant feeding guidelines current at the time. Results: Breastfeeding cessation occurred earlier in HIVIGLOB/NVP compared with HIVNET 012 (median 4.0 versus 9.3 months, P < 0.001). Rates of serious gastroenteritis were higher in HIVIGLOB/NVP (8.0/1000 child-months) than in HIVNET 012 (3.1/1000 child-months; P < 0.001). Serious gastroenteritis events also peaked earlier at 3-4 and 7-8 months (16.2/1000 and 15.0/1000 child-months, respectively) compared with HIVNET 012 at 9-10 months (20.8/1000 child-months). All cause infant mortality did not statistically differ between the HIVIGLOB/NVP and the HIVNET 012 trials [3.2/1000 versus 2.0/1000 child-months, respectively (P = 0.10)]. Conclusions: Early breastfeeding cessation seen in the HIVIGLOB/NVP trial was associated with increased risk of serious gastroenteritis among HIV-exposed uninfected infants when compared with later breastfeeding cessation in the HIVNET 012 trial. Testing interventions, which could decrease HIV transmission through breastfeeding and allow safe breastfeeding into the second year of life, are urgently needed.

Infectious Diseases

Microbiology

Virology

Fundamental and applied biological sciences. Psychology

Miscellaneous

Viral diseases

Biological and medical sciences

Medical sciences

Human viral diseases

Details

Title: Subtitle: Early Weaning of HIV-Exposed Uninfected Infants and Risk of Serious Gastroenteritis: Findings from Two Perinatal HIV Prevention Trials in Kampala, Uganda
Creators: Carolyne ONYANGO-MAKUMBI - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
Danstan BAGENDA - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
J Brooks Jackson - Johns Hopkins Medical Institutions, Baltimore, MD, United States
Laura A GUAY - Johns Hopkins Medical Institutions, Baltimore, MD, United States
Antony MWATHA - Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Research Center, Seattle, WA, United States
Saad B OMER - Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
Philippa MUSOKE - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
Francis MMIRO - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
Sheryl L ZWERSKI - Division of AIDS, NIAID, NIH, Rockville, MD, United States
Brenda ASIIMWE KATEERA - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
Maria MUSISI - Makerere University-Johns Hopkins University Research Collaboration/MU-JHU CARE LTD, Kampala, Uganda
Mary Glenn FOWLER - Johns Hopkins Medical Institutions, Baltimore, MD, United States
Resource Type: Journal article
Publication Details: Journal of acquired immune deficiency syndromes (1999), Vol.53(1), pp.20-27
DOI: 10.1097/QAI.0b013e3181bdf68e
PMID: 19779355
PMCID: PMC2888913
NLM abbreviation: J Acquir Immune Defic Syndr
ISSN: 1525-4135
eISSN: 1944-7884
Publisher: Lippincott Williams & Wilkins; Hagerstown, MD
Language: English
Date published: 2010
Academic Unit: Pathology; VPMA - Administration
Record Identifier: 9984047624302771

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